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General NPI Number Information
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NPI Number | 1043885106
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Entity Type | Individual
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Provider Name | SARAH LAITE LISW
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Gender | Female
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 45875 BELL SCHOOL RD STE B
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-8728
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Country | US
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Telephone | 330-397-6007
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Fax | 234-254-5655
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Provider Business Mailing Address
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Address Line | 4941 HOPKINS RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44511-3623
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Country | US
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Telephone | 724-987-0139
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.174700
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2207528
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2405867
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License Number State | OH
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